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Review
. 2023 Aug;39(1):59-69.
doi: 10.1007/s12028-023-01752-y. Epub 2023 Jun 6.

Intracranial Pressure Monitoring and Management in Aneurysmal Subarachnoid Hemorrhage

Alberto Addis  1   2 , Marta Baggiani  3 , Giuseppe Citerio  4   5
Affiliations
Review

Intracranial Pressure Monitoring and Management in Aneurysmal Subarachnoid Hemorrhage

Alberto Addis et al. Neurocrit Care. 2023 Aug.

Abstract

Aneurysmal subarachnoid hemorrhage is a medical condition that can lead to intracranial hypertension, negatively impacting patients' outcomes. This review article explores the underlying pathophysiology that causes increased intracranial pressure (ICP) during hospitalization. Hydrocephalus, brain swelling, and intracranial hematoma could produce an ICP rise. Although cerebrospinal fluid withdrawal via an external ventricular drain is commonly used, ICP monitoring is not always consistently practiced. Indications for ICP monitoring include neurological deterioration, hydrocephalus, brain swelling, intracranial masses, and the need for cerebrospinal fluid drainage. This review emphasizes the importance of ICP monitoring and presents findings from the Synapse-ICU study, which supports a correlation between ICP monitoring and treatment with better patient outcomes. The review also discusses various therapeutic strategies for managing increased ICP and identifies potential areas for future research.

Keywords: Intracranial pressure; Review; Subarachnoid hemorrhage.

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Conflict of interest statement

GC reports grants and personal fees as a speakers’ bureau member and advisory board member for Integra and Neuroptics. AA and MB have no conflicts to report.

Figures

Fig. 1
Fig. 1
Flowchart summarizing the management of intracranial pressure (ICP) monitoring after aneurysmal subarachnoid hemorrhage (SAH). Details in the text
Fig. 2
Fig. 2
Strategies for controlling intracranial pressure (ICP). See text for details
See this image and copyright information in PMC

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